Medical insurance reimbursement ratio for urban and rural residents in 2023 is categorized into students, elderly people over 70 years old, other urban residents and so on.
1, students
In a billing year, incurred in line with the scope of reimbursement of medical expenses, the starting standard for reimbursement of tertiary hospitals is 55%; the starting standard for reimbursement of secondary hospitals is 60%; the first level of hospitals do not have a starting standard, reimbursement rate of 65%.
2. For elderly people aged 70 or above
In a settlement year, the starting rate for medical expenses eligible for reimbursement is 50% for Level III hospitals; 60% for Level II hospitals; and 65% for Level I hospitals without any starting rate.
3. For other urban residents
In a settlement year, if they have incurred medical expenses within the scope of reimbursement, the starting rate of reimbursement is 50% for Level III hospitals; 55% for Level II hospitals; and 60% for Level I hospitals without any starting rate.
Not covered by medical insurance:
I. Services
1, registration fees, out-of-hospital consultation fees, and the cost of medical records.
2, consultation fee, examination and treatment of expedited fee, name surgery surcharge, quality and price fee, self-employed special nurse and other special medical services.
2. Non-disease treatment programs
1. Various beauty and fitness programs as well as non-functional cosmetic and orthopedic surgeries.
2, a variety of weight loss, fat, height projects.
3, all kinds of health checkups.
4, a variety of prevention, health care treatment programs.
5, a variety of medical consultation, medical appraisal.
Three, diagnostic and therapeutic equipment and medical materials
1, the application of positron emission tomography (PET), electron beam cT, ophthalmic excimer laser treatment device and other large-scale medical equipment for the examination and treatment program.
2, eyeglasses, dentures, eye prostheses, prosthetic limbs, hearing aids and other rehabilitative appliances.
3, a variety of self-use health care, massage, examination and treatment equipment.
4, the provincial price department regulations can not be charged separately for disposable medical.
Four, therapeutic items category
1, all kinds of organ or tissue transplantation of organ source or tissue source.
2, in addition to kidney, heart valve, cornea skin, blood vessels, bone, bone marrow transplantation, other organs or tissues transplantation.
3. Orthopedic surgery for myopia.
4, qigong therapy, music therapy, health care nutritional therapy, magnetic therapy and other complementary treatment programs.
Reference to the above: Baidu Encyclopedia-Medical Insurance